What is Nerve Stimulation and How Does it Work?

Stimulating nerves with electrical currents, as a way of treating pain, has been around for centuries. In fact, the technique was first reported in ancient Rome.

As time went on, and our understanding of how exactly electrical pulses alleviate pain grew, the technique was increasingly used in modern medicine.

The treatment, known as neurostimulation or neuromodulation, not only offers very effective relief from chronic pain such as back pain, and cancer-related pain, it is also an alternative for patients who haven’t seen good results from medication, or when other pain management strategies have failed.

How does nerve stimulation work?

To understand how nerve stimulation works, we must first understand how pain is perceived by the brain.

Pain is felt for a reason – it stops us from doing something that is causing us harm. If we touch a hot stove for example, we instantly know to pull our hand away, because it hurts.

Our pain receptors are stimulated and begin to release chemicals, which act as messengers. The message goes to our spinal cord, then up to our brain. Our brain processes the feeling and perceives it as painful. The whole process happens instantly, and we immediately know to stop doing the thing that hurts.

This is an example of an acute pain – it doesn’t normally last long, and once the burn has healed, the pain goes away. But chronic pain is very different – it is a pain that is persistent and lasts a long time. Chronic pain is also harder to manage, and the way pain is felt and processed differs.

Chronic pain and the nervous system

Over time, in people living with chronic pain, the chemical messengers that our body releases in response to pain can alter our nervous system. The changes can affect the type of pain felt and can alter our response, so it becomes more sensitive. In some cases, even the gentlest touch can be perceived as extremely painful. This is where nerve stimulation comes in, targeting the nerve cells that have been affected.

Cancer-related pain

Most cancer-related pain is caused by a tumor pressing on nerves, bones or other organs in the body. Chronic cancer-related pain can be caused by changes to the nerves as a result of cancer pressing on them, or due to a tumor producing chemicals. It may also be caused by nerve changes because of cancer treatment.

Nerve stimulation – the basics

To understand nerve stimulation, let us look at transcutaneous electrical nerve stimulation – or TENS – a technique that has been commonly used since the 1960s. Small electrodes, which conduct electricity, are placed on the skin at the site of the pain. The electrodes are then attached via wires to a device that releases electrical pulses.

The pulses interrupt the messages that your body is sending to the brain about the pain you are feeling. The pain receptors are blocked, and the nerves are unable to tell the brain that it hurts. Without these messages, the brain doesn’t know that you are in pain – so you can’t feel it.

Modern interventional techniques

In recent years, this approach to pain relief has evolved dramatically. State-of-the-art techniques using tiny devices can offer significant relief.

While the techniques all work in slightly different ways and can target pain related to a wide range of conditions, the approach to stimulating nerves to interrupt pain signals remains the same.

The team at Cleveland Clinic Abu Dhabi’s Interventional Pain Management Center offer the widest range of cutting-edge, minimally invasive interventional methods in the region.

Spinal Cord Stimulation (SCS) is an advanced pain management procedure used to alleviate chronic and severe cancer-related pain that is not adequately controlled with conventional pain management methods, who may not be suitable candidates for surgery or those who experience intolerable side effects from pain medications. During this minimally invasive procedure, a small device is implanted under the skin near the spinal cord. The stimulator generates electrical impulses that target and modify pain signals before they reach the brain. These impulses create a tingling sensation that helps to reduce or block the perception of pain, providing significant pain relief for patients.

In fact, the center was the first in the Middle East to offer something called differential target multiplexed (DTM) spinal cord simulation (SCS), the very latest interventional technique for patients with chronic back and leg pain following surgery. The procedure targets not one, but two types of nerve cells involved in the pain pathway: the neurons and the glial cells, and as a result, over 80% of patients who undergo the procedure report a notable reduction in their pain.

Dorsal root ganglion (DRG) stimulation is another new treatment, only available in the UAE at Cleveland Clinic Abu Dhabi, which offers significant pain relief for patients living with chronic intractable pain conditions such as neuropathic cancer pain. Electrodes are implanted on the dorsal root ganglion – cells which experts now believe form the ‘nerve center’ of the spinal cord.

DRG offers highly targeted pain relief with improved pain control for patients with chronic and neuropathic cancer pain that is affecting specific areas of the body.

For patients living with chronic neuropathic pain, a minimally invasive treatment known as peripheral nerve stimulation (PNS) can offer effective relief. A very thin wire is implanted next to the peripheral nerves (those extending out to our organs and extremities) and delivers precise electrical pulses to interfere with the pain signals at the exact source of the pain.

The use of electrical stimulation to treat pain has certainly come a long way. A range of state-of-the-art techniques are now available to offer effective relief to those living with chronic pain caused by a number of conditions. Talk to your doctor to learn more.